Let’s start with some good news: Women are continuing to live longer with metastatic breast cancer than ever before, due to better treatments and understanding of the disease. In fact, survival rates for women diagnosed with late-stage breast cancer is double what it was 25 years ago. Progress! Nevertheless, the five-year rate still lingers around 36% for women under 50—so it’s understandable why you’re stressed if you’ve recently been diagnosed. As your doctor and fellow MBC patients will undoubtedly tell you, though, worrying about tomorrow is wasted energy. What you need is a solid action plan to zero in on the right now and make every day a chance to live your best life, MBC be damned. There are 31 days in Breast Cancer Awareness Month, and we’ve got a tip for living your best life for each one.
1. It’s OK to Skip a Visit
Bet you didn’t see that one coming! Look, we’re not saying it’s optimal. But there are going to be days with MBC where you simply cannot face another doctor’s office, and it’s ultimately up to you to decide whether to go. Your guiding light: Choose what feels right to you, even if that means only attending the appointments that are absolutely necessary, and not much more. “Individuals have different needs and comfort zones and may not choose to focus their life around their disease at all,” says Julie L. Salinger, a clinical social worker at Dana Farber Cancer Institute in Boston.
2. Call for Backup
Then again, sticking with your doc visits is a good thing—and can be made easier with the right team in place. “Patients will likely benefit from creating a strong scaffolding around them including counseling, alternative treatment providers, and a support group,” says Salinger.
3. Lower Your Living Costs
If you have MBC, you know one of the biggest stressors is financial. When you should be focused on your health, you’re instead worrying about paying medical bills and keeping up with the rent, says Terri Strong, an oncology clinical social worker at Duke University Health System. Visit the Cancer Financial Assistance Coalition for info on help covering the cost of care, wigs, testing, legal help, and more.
4. Get Help Paying for Meds
Many women with metastatic breast cancer are on oral chemotherapy or other treatments like estrogen mediators such as letrozole. Insurance often covers much of this, but if yours doesn’t (or you don’t have any), nonprofits like Rx Hope can offer longer-term assistance.
5. Do Yoga
The bendy practice is celebrated for its ability to keep you centered—literally. Besides the mental health benefits of feeling grounded, restorative yoga can help with balance, which tends to degrade over time and can be affected by fatigue. Yoga poses will also increase blood flow, which helps your body (and brain) function better.
6. Find a Palliative Care Doctor
Yes, that word is scary, and yes, a lot of people end up seeing a palliative care specialist when they and their oncology team decide to discontinue treatment. But that doesn’t have to be the case. Palliative care doctors can help patients manage pain, sort through treatment options, and introduce holistic treatments, like mind-body care.
7. See a Shrink
There are few things more stressful than wondering if and when your meds will stop being effective. “Metastatic breast cancer patients are on a treatment as long as it works,” says Parker Anderson, a medical family therapist at Duke Cancer Institute. “It’s an intense way to live.” Living under that pressure can be consuming, and speaking with someone that you don’t have emotional ties to can be extremely helpful.
8. Get to Know CBT
It stands for cognitive-behavioral therapy, and a review of research in the journal Psycho-Oncology found this method of mental health treatment greatly improved depression and anxiety among breast cancer patients. The technique focuses on challenging unhelpful thoughts, giving people the tools to change their perspective, and offering a stronger sense of control over their destiny. Google cognitive-behavioral therapists to find one in your area.
9. Don’t Read Test Results Solo
As more healthcare companies adopt Electronic Medical Record (EMR) systems, patients can often access test results as soon as they become available, rather than hearing it from their doctor. Don’t do it. “With MBC, it’s much better to have a discussion with your doctor who can interpret the results for you,” says Sarah Sammons, M.D., a medical oncologist specializing in breast cancer at Duke Health in Durham, N.C. Your doctor can contextualize the findings and help adjust your treatment plans.
10. Actually, Don’t Read Them at All
Sounds counterintuitive, right? But for some women who have a care team they trust, less information is better, says Dr. Sammons. This way, your doc tracks the scans and fiddles with meds, while you focus living your life. It’s not that your doctor will keep anything important from you, but for some, it prevents unhelpful obsessing and lifts the burden of needing to be on top of every little twist and turn in your cancer.
11. Check on Your Kids
No matter how old your children are, they feel it when you’re sick. Talking with them about what’s going on can lift a weight from your shoulders—and theirs. But what you say depends on whether you’re talking with tots or young adults. Speak with a family therapist to plan exactly what you want to say. You can even write it down and practice it.
12. Read This Book
For a zap of encouragement, pick up Radical Remission: Surviving Cancer Against All Odds. Author and oncology researcher Kelly Turner, Ph.D., describes her studies on holistic and non-traditional approaches after conventional breast cancer treatment has failed. The book doesn’t offer false hope—but lays out the scientific evidence that there are methods of intervention beyond what’s written in medical textbooks.
13. Find Your Peeps
Nobody understands what you’re going through better than people going through it themselves. Check with your local hospital: Many host support groups for metastatic patients. No dice? Check out Metavivor, an organization that promotes metastatic research and awareness, and hosts peer-to-peer support groups across the country.
14. Beat Scanxiety
Fear of recurrence or spread can make scans a time of high anxiety—a phenomenon that’s been coined “scanxiety.” Since you’re probably getting scans a lot, you need a mental approach. Give yourself a set amount of time—say, two days before a scan—to stress about it, says Parker Anderson, a medical family therapist at Duke Cancer Institute. Outside of that window, work on shelving those thoughts in the back of your mind. Scheduling a specific amount of time to thinking about your scan lets you acknowledge its importance without taking over your life, Anderson adds.
15. Control Communication
Sometimes, cancer patients feel overwhelmed by having to constantly update well-meaning family and friends on how they’re doing. Designate someone in your inner circle as a PR manager, suggests Kathleen Ashton, Ph.D., a psychologist at the Cleveland Clinic in Ohio. Or use a site like CaringBridge.com that allows people you’ve invited to view updates that you post.
16. Practice Body Neutrality
It’s a growing trend in psychology, and one that works well when you’re trying to balance positive vibes with the reality of a difficult situation. Rather than force yourself to think of everything you love about yourself right now, try thinking about your body and health status as something that just is. Accepting yourself is the first step towards lowering stress levels and improving confidence. Just be you.
17. Clarify Your Priorities
In the craze of daily life, it’s easy to lose track of what matters most. Self-evaluations like this one help you see what gives your life meaning—romantic love, family, friendships, intellectual pursuits, work—as well as what your core values are, including curiosity, courage, and creativity. “You’ll answer the question: ‘Am I really doing what I want to be doing with my life?’” says Ashton. Figuring that out will help you prioritize your time accordingly.
18. Be Mindful of Bucket Lists
“It’s always a good idea to have short- and long-term goals,” says Salinger. “Bucket lists are fine as long as you have the ability to modify a dream to make it possible if circumstances of your disease prevent travel or a special event.” No one needs to tell you: Being a cancer patient requires a lot of patience and flexibility. So make your moonshot list, then make your must-do-this-year list, and get to work on both.
19. Eat Ice Cream. Right Now.
“If not now, when?” is the ultimate cliché—unless you have MBC, and then it’s a pretty accurate assessment of your reality. Life has an expiration date for everyone, MBC or not. And so does that carton of Ben & Jerry’s. So now might just be the very best time to dig in and celebrate your awesomeness.
20. Share Your Goals With Your M.D.
Dreaming of hiking the Appalachian Trail? Want to drive across country with your hubby? Planning treatment around big events like these is tricky—but totally doable if you have open communication with your oncologist. Talk with your doc about moving appointments around, or whether there’s a less aggressive schedule you can follow during these times, says Dr. Sammons.
21. Give Yourself a Break
There’s a growing sentiment in some support groups that cancer patients need to be warriors. And while there’s a lot to be said for having a positive, I-can-beat-it outlook, it can also be exhausting. If you have cancer, you’re allowed to feel anxious, angry, sad—it’s all legit. Your only duties as an MBC patient are to adhere to your treatment protocol, take care of yourself, and be honest with yourself and others about what you’re going through.
22. Create a Legacy Project
Maybe you want to put together a scrapbook, make a photo collage, sketch your family tree, or write letters to loved ones. It’s not about saying goodbye, but about reminding yourself of what a rich trove of memories and friendships you have to draw on for strength. Such projects can ease anxiety and improve communication among family members, according to researchers at the University of Alabama in Tuscaloosa.
23. Keep a Journal
Journaling can help you put words to feelings, and has been shown to help manage anxiety, reduce stress, and cope with depression, according to experts at the University of Rochester Medical Center. Need some prompting? Start by thinking of a word that describes how you feel right now. Then write down every other word you can think of that’s associate with that word, and then more words that are associated with the ones you’ve just written. When you’re done, go back to the top and write down a word that means the opposite of every negative one on the list.
24. Try Relaxation Techniques
These can include mindfulness meditation or mindfulness-based stress reduction (MBSR) which focuses on body awareness, deep breathing, and progressive muscle relaxation. A mental health expert who does cognitive behavioral therapy can lead you in some of these techniques. And there are tons of apps out there, but Stop, Breathe, and Think is a good place to start.
Building or maintaining muscle mass can help you feel strong mentally and physically. It can be hard, especially if you’re on meds that have side effects like fatigue or neuropathy, which causes numbness in extremities. See if your hospital has exercise classes for patients or check out Johns Hopkins Medicine’s workout videos, which include cardio, strength training, and yoga for cancer patients.
26. Visit an Acupuncturist
Aromatase inhibitors that block the body’s estrogen production—anastrozole, exemestane, and letrozole—can cause joint pain or stiffness. For some women, it’s so bad that they stop taking the meds entirely. Some research suggests that acupuncture may reduce this pain, allowing women to take these aromatase inhibitors for longer.
27. Eat Protein
Protein can help you maintain muscle mass and stave off fatigue—two things you’ll be needing right about now. Focus on lean proteins like chicken, fish, beans, and lentils, while staying away from smoked and cured meat. Soy is another good form of protein, and despite what you may have heard, it does not cause breast cancer (because animals, which were used in the studies, metabolize soy differently than humans, according to the experts at the Cleveland Clinic).
28. Get a Massage
Your body has been through a lot. Now is a good time to let it know you appreciate all it has done by treating yourself to a gentle massage. Check with your doctor to be sure it’s OK, and let your massage therapist know your health status, since it can affect things like using less pressure and finding a comfortable body position. (If you’ve recently had breast surgery or have tenderness, ask to lie on your back or sit in a chair for the massage.)
29. Keep Pain in Check
If pain is creeping in, it can stop you from doing what you want to do—and wreak mental health havoc, too. Talk with your doctor about the range of pain medication options, and together you can figure out which course is best for you. Also, a review in the Annals of the New York Academy of Science found that mindfulness meditation may help reduce chronic pain without the need for narcotics.
30. Inhale Lavender
It’s been used for years to quell anxiety, and recent research confirms that inhaling the scent of lavender can indeed induce relaxation, partly by slowing down your central nervous system response. Place a few drops of lavender oil in a warm bath or on your pillow before going to bed at night.
31. Commit to Hope
No one with MBC is naïve. You know the journey you’re on offers no promises. But doesn’t guarantee doomsday, either—especially as treatments continue to improve. So if you’re choosing between hope and defeat, choose hope. “While difficult, try hard to balance hope and reality, recognizing that at times the harsh reality will reign supreme and at other times hope is easier to access,” says Salinger. “Recognize that what you hope for may change over time as your situation changes, but there is always room for hope.”